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Published on: June 2, 2014
Emergency department management of primary headache disorders in pediatric patients
Lujain F Abul1, Aidan McParland2, Garth D Meckler3
1Pediatric Emergency Medicine Fellow, University of British Columbia, Pediatric Emergency Medicine, BC Children's Hospital, Vancouver, BC, Canada.
Insights
Pediatric headaches require distinguishing primary causes like migraines from dangerous secondary ones. This review covers diagnosis, treatment options, and patient education for managing childhood headaches effectively.
Area of Science:
- Pediatric Emergency Medicine
- Neurology
- Clinical Pediatrics
Background:
- Headaches are a frequent cause for emergency department visits in children.
- Accurate diagnosis is crucial to differentiate primary headaches (e.g., migraine) from secondary causes.
Purpose of the Study:
- To provide guidance on diagnosing primary headaches in children using history and physical examination.
- To outline first-line treatments for primary headaches and options for severe or refractory migraines.
- To discuss procedural interventions and patient education strategies for headache management.
Main Methods:
- Review of diagnostic approaches focusing on clinical history and physical examination.
- Discussion of therapeutic strategies including pharmacologic and non-pharmacologic interventions.
- Inclusion of guidance on patient and family education regarding triggers and lifestyle modifications.
Main Results:
- Emphasis on the importance of thorough patient history and physical exam for accurate diagnosis.
- Presentation of various treatment options for primary headaches and complex migraines.
- Highlighting the role of education in managing pediatric headaches through lifestyle adjustments and nutraceuticals.
Conclusions:
- Effective management of pediatric headaches relies on accurate diagnosis and tailored treatment plans.
- Patient and family education is key to addressing triggers and implementing preventative strategies.
- Procedural interventions offer alternatives when standard therapies are insufficient for severe cases.
Abstract:
Headaches are a common reason for pediatric visits to the emergency department. Emergency clinicians must distinguish between common and dangerous secondary causes of headache and primary headache disorders such as migraine and tension-type headaches. This issue discusses the diagnosis of primary headaches by history and physical examination, the options for first-line treatment of primary headache and for severe or refractory migraines, and procedural interventions that may be considered when other therapies have failed. Guidance is provided for patient and family education regarding triggers, lifestyle modifications, and nutraceutical prophylaxis.
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